Your Child's Health: Inside the (lunch) box

Tuesday

Aug 28, 2007 at 12:01 AMAug 28, 2007 at 10:20 AM

With the confusing food pyramid and ever-changing food guidelines, coupled with school days that barely allow for time to eat lunch, it is truly a challenge to get kids a proper midday meal. Here are a few tips that could help.

Dr. Gwenn Schurgin O'Keeffe/Daily News correspondent

My family has a tradition of getting all our back-to-school shopping completed just before our big end-of-the-summer vacation. Lunch boxes used to be big ticket back-to-school items but since my girls are tweens now, as Hilary Duff once sang, that's "so yesterday." Plus, on most school days we're lucky if their lunches make it from the frig to their backpacks!

If only the choice of what to have for lunch these days were as easy as whether to brown bag it or have a fancy lunch box. With the confusing food pyramid and ever-changing food guidelines, coupled with school days that barely allow for time to eat lunch, it is truly a challenge to get kids a proper lunch.

Don't view nutrition as one meal but view it as a group of meals that balance out together and function like a bank; lunch may very well be the new breakfast, meaning our kids most important energy meal.

Lunch specifics
As my kids have gotten older, I've realized that helping them eat healthy is a balance between offering healthy foods, giving them control of some of their meals, and helping them learn to incorporate the less healthy foods with the healthy foods. Concerning lunch specifically:

Given how much of their day is decided by others, especially at school, I give my kids total control over what they have for lunch among the foods we have at home.

I've started to realize that lunch is not just a meal in a day but a meal that has to get my kids through the entire day including learning and after-school activities. It is perhaps their most important energy meal when viewed this way.

Fruits and veggies are crucial to their overall growth but don't always get that energy jolt needed to learn. So, I tend to reserve fruits and veggies for dinner and after-school snacks and add more carbohydrates, like pretzels and granola bars, for lunch and in-school snacks. The energy they provide lasts longer for my girls.

It occurred to me that getting through a school day is like a mini marathon for my kids but involving both body and mind. Just like with a marathon, hydration becomes as crucial as energy. So, I've put more emphasis on what they drink during the day and how much.

When my kids have a sugary snack occurring at school, we don't pack a snack that day or pack veggie sticks but leave lunch untouched. Lunch needs to happen as planned to learn well.

Kids and food: The big picture
These concepts that have helped me, can work for your kids, too. In addition, you have to remember that kids have simple tastes - which is why kids' menus have the same five foods on them regardless of the restaurant! And, unlike us parents, kids can truly eat the same meal every day without getting bored. I swear my youngest daughter will one day become a ham or waffle!

As I mentioned earlier, considering lunch in the big picture of your child's overall nutrition is really helpful. The government's new food pyramid (www.mypyramid.gov) gives a great visual description of what kids should eat during the day but it can be overwhelming. I know my kids don't come anywhere close to what the pyramid suggests for a given day but their nutrition is fine if I take into account what they eat over the course of a few days. So, if one day has more carbohydrates or fewer fruits, I help them make up for it the next day. If one day has an extra treat built in, we skip dessert.

Your kids' food bank
Give and take, and balance. Those are the ultimate ingredients to success. Each meal has its own role in a child's day. Breakfast jump starts our bodies after a long sleep. Dinner helps us refuel after the afternoon of physical and mental work and gives us fuel to keep our bodies going while we sleep.

Lunch, on the other hand, has to catch us up from the morning and get us through the afternoon until dinner. A lot is being asked of our kids through the day, and lunch has to meet all those needs, including physical growth. In many ways, breakfast and lunch need to be a bit more carbohydrate slanted and snacks and dinner more balanced with fruits and vegetables.

Lunch is tricky not only for how brief it is in most schools but because of how important it is. Kids have to make up for energy lost from the morning and store energy for the afternoon, and eat it in about 10 minutes.

Pre-cut fruits and vegetables and even prepackaged items such as the new 100-calorie packs are very useful for both purposes. The 100-calorie packs also visually teach portion control, which is very useful for prepubertal and early pubertal kids who are primed to gain weight entering puberty.

Using these items may not seem healthy to you but it's what the kids like to eat and what they see their friends eating.

Sandwiches tend to be the best way to get grains and proteins done all at once and are easy to eat quickly. Kids tend to not like the taste of the real grainy breads so try the grain or wheat breads that look like white. My kids can't tell the difference.

For hydration with lunch, my choice is water. Kids don't get enough during the school day and while I understand that school nutritionists view lunch as a way of getting calcium into our kids, we can do that at home. What our kids need is water and more of it during school.

My kids hate buying lunch at school but I know many kids who love school lunches. The problem is school lunches are not always as balanced as they should be. On days your child buys lunch, plan dinners higher in proteins, fruits and vegetables and less in fats and carbohydrates to balance out the day better. Be sure you ask your kids specifically what they had for lunch if they buy to help you plan meals better.

No school year would be complete without the birthday treats and special events but that extra sugar load need not derail our child's nutrition train. You can plan a healthier lunch the day of the treat or the next day to balance out the extra treat. Or, just skip dessert with dinner that night.

I'm a believer that our kids can have a daily treat but if it happens at school, then it doesn't happen after school. This is how our kids learn to incorporate the sweets into a normal diet without adding pounds.

Gwenn Schurgin O'Keeffe, M.D., is an urgent care pediatrician and mother of two from Wayland who practices with Harvard Vanguard Medical Associates. A graduate of Tufts University School of Medicine, Dr. O'Keeffe completed her residency training at New England Medical Center and practices in Natick. Contact Dr. O'Keeffe at ideas@pediatricsnow.com.

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